STOJAK v. SECRETARY OF HEALTH AND HUMAN SERVICES

In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 22-685V
KIMBA STOJAK,
Petitioner,
v.
SECRETARY OF HEALTH AND
HUMAN SERVICES,
Respondent.
Chief Special Master Corcoran
Filed: December 2, 2025
Leah VaSahnja Durant, Law Offices of Leah V. Durant, PLLC, Washington, DC, for
Petitioner.
Eleanor Hanson, U.S. Department of Justice, Washington, DC, for Respondent.
FACT RULING ON ONSET1
On June 17, 2022, Kimba Stojak filed a Petition for compensation under the
National Vaccine Injury Compensation Program, 42 U.S.C. §300aa-10, et seq.2 (the
“Vaccine 	Act”), 	alleging 	that 	she 	suffered 	a 	shoulder 	injury 	related 	to 	vaccine
administration (“SIRVA”) as a result of an influenza (“flu”) vaccine administered to her on
October 23, 2021. See Pet. at 1, ECF No. 1; see also Am. Pet, ECF No. 15. The case
was assigned to the Special Processing Unit of the Office of Special Masters.
For the reasons discussed below, I find it more likely than not that the onset of
Petitioner’s shoulder pain occurred within 48 hours of vaccination, as alleged.
1 Because this Ruling contains a reasoned explanation for the action taken in this case, it must be made
publicly accessible and will be posted on the United States Court of Federal Claims' website, and/or
at https://www.govinfo.gov/app/collection/uscourts/national/cofc, in accordance with the E-Government
Act of 2002. 44 U.S.C. § 3501 note (2018) (Federal Management and Promotion of Electronic Government
Services). This means the Ruling will be available to anyone with access to the internet. In accordance
with Vaccine Rule 18(b), Petitioner has 14 days to identify and move to redact medical or other information,
the disclosure of which would constitute an unwarranted invasion of privacy. If, upon review, I agree that
the identified material fits within this definition, I will redact such material from public access.
2 National Childhood Vaccine Injury Act of 1986, Pub. L. No. 99-660, 100 Stat. 3755. Hereinafter, for ease
of citation, all section references to the Vaccine Act will be to the pertinent subparagraph of 42 U.S.C. §
300aa (2018).
Case 1:22-vv-00685-UNJ Document 42 Filed 01/06/26 Page 1 of 8

2
I. 	Relevant Procedural History
Following Respondent’s medical review of the claim, the parties made a tentative
effort to settle this matter but were ultimately unsuccessful. ECF Nos. 24-29, 31-36.
Respondent filed his Rule 4(c) Report on March 13, 2025, arguing that Petitioner has not
established a Table SIRVA claim because she cannot show that the onset of her injury
occurred within 48 hours of vaccination. ECF No. 39 at 8. Petitioner has not filed any
documents in response. The issue of onset is ripe for resolution.
II. 	Authority
Pursuant to Vaccine Act Section 13(a)(1)(A), a petitioner must prove, by a
preponderance of the evidence, the matters required in the petition by Vaccine Act
Section 11(c)(1). “Medical records, in general, warrant consideration as trustworthy
evidence. The records contain information supplied to or by health professionals to
facilitate diagnosis and treatment of medical conditions. With proper treatment hanging in
the 	balance, 	accuracy 	has 	an 	extra 	premium. 	These 	records 	are 	also 	generally
contemporaneous to the medical events.” Cucuras v. Sec’y of Health & Hum. Servs., 993
F.2d 1525, 1528 (Fed. Cir. 1993).
Accordingly, where medical records are clear, consistent, and complete, they
should be afforded substantial weight. Lowrie v. Sec’y of Health & Hum. Servs., No. 03-
1585V, 2005 WL 6117475, at *20 (Fed. Cl. Spec. Mstr. Dec. 12, 2005). However, this rule
does not always apply. In Lowrie, the special master wrote that “written records which
are, themselves, inconsistent, should be accorded less deference than those which are
internally consistent.” Lowrie, 2005 WL 6117475, at *19.
The United States Court of Federal Claims has recognized that “medical records
may be incomplete or inaccurate.” Camery v. Sec’y of Health & Hum. Servs., 42 Fed. Cl.
381, 391 (1998). The Court later outlined four possible explanations for inconsistencies
between contemporaneously created medical records and later testimony: (1) a person’s
failure to recount to the medical professional everything that happened during the relevant
time period; (2) the medical professional’s failure to document everything reported to her
or him; (3) a person’s faulty recollection of the events when presenting testimony; or (4)
a person’s purposeful recounting of symptoms that did not exist. La Londe v. Sec’y of
Health & Hum. Servs., 110 Fed. Cl. 184, 203-04 (2013), aff’d, 746 F.3d 1335 (Fed. Cir.
2014). The Court has also said that medical records may be outweighed by testimony
that is given later in time that is “consistent, clear, cogent, and compelling.” Camery, 42
Fed. Cl. at 391 (citing Blutstein v. Sec’y of Health & Hum. Servs., No. 90-2808, 1998 WL
408611, at *5 (Fed. Cl. Spec. Mstr. June 30, 1998)).
Case 1:22-vv-00685-UNJ Document 42 Filed 01/06/26 Page 2 of 8

3
A special master may find that the first symptom or manifestation of onset of an
injury occurred “within the time period described in the Vaccine Injury Table even though
the occurrence of such symptom or manifestation was not recorded or was incorrectly
recorded as having occurred outside such period.” Section 13(b)(2). “Such a finding may
be made only upon demonstration by a preponderance of the evidence that the onset [of
the injury] . . . did in fact occur within the time period described in the Vaccine Injury
Table.” Id.
The special master is obligated to fully consider and compare the medical records,
testimony, and all other “relevant and reliable evidence contained in the record.” La
Londe, 110 Fed. Cl. at 204 (citing § 12(d)(3); Vaccine Rule 8); see also Burns v. Sec’y of
Health & Hum. Servs., 3 F.3d 415, 417 (Fed. Cir. 1993) (holding that it is within the special
master’s discretion to determine whether to afford greater weight to medical records or to
other evidence, such as oral testimony surrounding the events in question that was given
at a later date, provided that such determination is rational).
III. 	Relevant Factual Evidence
I make this finding of fact after a complete review of the record, including all
medical records, declarations, and additional evidence filed, and in particular the
following:3
• 	Petitioner received the subject flu vaccine in her left deltoid on October 23,
2021, at her place of employment. Ex. 1 at 2.
• 	In her signed declaration, Petitioner attests that she “felt a ‘swoosh’ followed
by a burst of fluid in [her] upper arm” from her October 23, 2021 vaccination.
Ex. 7 ¶ 1. She acknowledged that she was “surprised [she] did not have the
injection site soreness.” Id. But by “[t]he next night . . . [her] entire upper left
arm started throbbing and was very painful.” Id. Petitioner stated the pain
continued after taking ibuprofen and using home remedies, and she began
having soreness with lifting her arm to the side or behind her. Id. She also
recalls that on October 28, 2021, while “on site at one of [her] offices,” she
asked a former treater and colleague if “they could have hit something to
cause this” and was told “they may have hit a tendon or nerve” and it “should
resolve itself in 4-6 weeks” with at-home treatment. Id.
• 	During November 2021, Petitioner had several medical encounters, but she
did not mention left shoulder pain at any visit. For instance, on November
3 While I have reviewed all the evidence filed to-date in this case, only evidence related to onset will be
discussed herein, though other facts may be provided as necessary.
Case 1:22-vv-00685-UNJ Document 42 Filed 01/06/26 Page 3 of 8

4
1, 2021, Petitioner obtained a prescription refill of meloxicam (which she
was previously prescribed to treat cervical spondylosis)4 from an internal
medicine physician with whom she worked. Ex. 4 at 169-70. On November
5, 2021, Petitioner had a mammogram screening, and on November 8,
2021, she had an ophthalmology appointment. Id. at 159-68, 142-58
(reverse order).
• 	On December 11, 2021, Petitioner received a COVID-19 vaccine. Ex. 2 at
23. This event appears to have been self-reported by Petitioner, however,
and the immunization records do not identify a situs of administration for
this vaccination. See id.
• 	On January 6, 2022 (approximately 75 days post vaccination), Petitioner
sought care with another internal medicine specialist, for complaints of left
shoulder pain for the “last 2 mo. [sic].” Ex. 2 at 21. Petitioner “[i]nitially []
thought [her shoulder pain] could be related to [the] vaccination.” Id. She
reported that taking over-the-counter medication “ha[d] not been helping
much[;]” and she requested a cortisone injection. Id. The treater assessed
Petitioner with acute left shoulder pain and administered her a steroid
injection.5 Id. at 21, 23.
• 	Petitioner underwent an x-ray of her left shoulder on January 14, 2022. Ex.
2 at 11. She reported “[p]ain since getting flu shot 12/21.” Id. The history of
her injury was listed as “lt [sic] upper arm pain since flu shot 3-4 months
ago.” Id. Petitioner’s treater felt the x-ray results were normal, in that it “looks
to be a soft tissue problem, no arthritis.” Id. at 8.
• 	On January 21, 2022, Petitioner had an appointment with an orthopedist for
left shoulder pain. Ex. 4 at 115. Petitioner reported that “[b]ack [on]
10/23/2021, she had a flu vaccine injection . . . and has had pain since.” Id.
Specifically, she “felt a ‘swoosh’ when it occurred and has pain along the
entire deltoid area and then anterior shoulder.” Id. The orthopedist assessed
Petitioner with rotator cuff tendinitis with deltoid myositis. Id. Petitioner was
4 Though not a basis on which Respondent contests Petitioner’s onset (or Table SIRVA) contentions,
Respondent notes that Petitioner’s medical history is relevant for cervical spine osteoarthritis with
radiculopathy, beginning in 2019. Rule 4(c) Report at 2 (citing Ex. 4 at 107). Respondent argues, however,
that “[t]o the extent [this] previously-diagnosed cervical radiculopathy contributed to [Petitioner’s]
symptoms, these contributions would not be considered as past of her alleged SIRVA.” Id. at 10, n.5.
5 While Respondent contends that Petitioner received a second COVID-19 vaccine during this visit, the
record appears to show that Petitioner’s prior December 11, 2021 vaccination was “reviewed” during this
January 6 th visit, not that another dose was administered on this date. Ex. 2 at 23. Regardless, the record
does not identify vaccine situs for this (or Petitioner’s first) alleged COVID vaccination.
Case 1:22-vv-00685-UNJ Document 42 Filed 01/06/26 Page 4 of 8

5
prescribed medications, referred to physical therapy, and placed on a
limited duty work restriction (to include limited lifting). Id. at 115-16.
• 	Petitioner began occupational and physical therapy on January 25, 2022.
Ex. 4 at 107. The date of onset was listed as “10/23/2021,” and Petitioner
reported “left shoulder pain that appeared after receiving a flu shot in
October.” Id. She noted that “[t]he pain has been constant since its onset,
with it progressively worsening up until this past week.” Id.
• 	On February 18, 2022, Petitioner had a follow-up orthopedic appointment.
Ex. 4 at 78. The treater noted Petitioner’s diagnosis of rotator cuff tendinitis
with deltoid myositis that all “happened after [a] flu vaccine injection.” Id.
• 	Similarly, during an April 1, 2022 orthopedic follow-up visit, the treater wrote
that Petitioner “continue[d] to have left shoulder pain after [f]lu injection.” Ex.
4 at 40. More so, later that month (on April 25, 2022), the orthopedist noted
Petitioner’s history in that she had “persistent left shoulder pain after flu
injection 10/23/2021.” Id. at 15.
• 	On May 16, 2022, Petitioner saw an orthopedic surgeon. Ex. 6 at 272.
Petitioner complained of “new left shoulder pain[,]” specifically “pain post flu
vaccine in 2021.” Id. Additionally, Petitioner denied any problems with the
left shoulder “prior to receiving the mandatory flu vaccination in 2021.” Id.
• 	Petitioner began a round of physical/occupational therapy on July 5, 2022.
Ex. 6 at 153. She described her history and stated that her “[i]nitial pain
began last year following injection for flue [sic] vaccine which brought about
pain in her left shoulder.” Id. at 154.
• 	In support of her claim, Petitioner submitted a letter from her original treating
internal medicine specialist,6 dated August 26, 2024. Ex. 11. The physician
recalled a conversation at their employee clinic with Petitioner “in October
2021 just a few days after receiving her flu vaccine.” Id. at 1. Petitioner
asked “if it was possible they ‘hit’ something in her arm when they
administered her vaccine over that weekend on October 23.” Id. According
to the physician, Petitioner felt “an explosion of fluid in her arm” upon
injection and “the next night” her whole left arm began throbbing and she
had difficulty with range of motion over a few days. Id.
6 This treater prescribed Petitioner meloxicam on November 1, 2021. Ex. 4 at 169-70.
Case 1:22-vv-00685-UNJ Document 42 Filed 01/06/26 Page 5 of 8

6
• 	No other medical record or declaration evidence regarding the onset of
Petitioner’s post vaccination shoulder injury has been filed.
IV. 	Finding of Fact Regarding Onset
A petitioner alleging a SIRVA claim must show that she experienced the first
symptom or onset within 48 hours of vaccination (42 C.F.R. § 100.3(a)(XIV)(B)), and that
her pain began within that same 48-hour period (42 C.F.R. § 100.3(c)(10)(ii) (QAI
criteria)). As noted, Respondent contends that Petitioner cannot establish this criterion
because she had two intervening medical encounters in the month of November 2021,
without mentioning left shoulder pain, and did not complain of left shoulder pain until 75
days post vaccination. Rule 4(c) Report at 8-9 (internal citations omitted). More so,
Respondent asserts that Petitioner’s physician letter and declaration cannot overcome
the contemporaneous medical records. Id. at 9.
The 	totality 	of 	the 	evidence 	favors 	Petitioner’s 	onset 	contentions. 	The
aforementioned medical records establish that Petitioner consistently reported to treaters
onset close-in-time to vaccination, that she sought treatment within two-and-a-half
months of the vaccination, and that she indeed was experiencing symptoms in the
relevant timeframe.
The fact that Petitioner delayed treatment a bit (seeking care within less than three
months of her vaccination (on January 6, 2022)) does not preclude Petitioner from
establishing Table-consistent onset. In other cases, even greater delays have not
undermined an otherwise-preponderantly-established onset showing consistent with the
Table. See, e.g., Tenneson v. Sec’y of Health & Hum. Servs., No. 16-1664V, 2018 WL
3083140, at *5 (Fed. Cl. Spec. Mstr. Mar. 30, 2018), mot. for rev. denied, 142 Fed. Cl.
329 (2019) (finding a 48-hour onset of shoulder pain despite a nearly six-month delay in
seeking treatment); Williams v. Sec’y of Health & Hum. Servs., No. 17-830V, 2019 WL
1040410, at *9 (Fed. Cl. Spec. Mstr. Jan. 31, 2019) (noting a delay in seeking treatment
for five-and-a-half months because a petitioner underestimated the severity of her
shoulder injury). The delay here is not nearly as long.
Delay in seeking treatment itself is not per se evidence of a non-conforming onset.
As I have previously noted, SIRVA petitioners often put off seeking shoulder-related care
based on the reasonable assumption that the pain is normal and will resolve on its own
over time, especially since patients are often told by medical providers at the time of
vaccination to expect some soreness and pain. This appears to have been (at least
partially) the case here, with Petitioner explaining that she was told by a treater the pain
Case 1:22-vv-00685-UNJ Document 42 Filed 01/06/26 Page 6 of 8

7
“should resolve itself” and she thus tried unsuccessfully to treat her pain with over-the-
counter remedies. See, e.g., Ex. 7 ¶ 1.
Likewise, 	the 	fact 	that 	Petitioner 	sought 	care 	on 	several 	occasions 	post-
vaccination 	without mentioning 	left 	shoulder 	pain does 	not 	fully 	detract 	from 	her
arguments on onset. For instance, Petitioner’s visits on November 5 and 8, 2021, were
with specialists or for preventative care. See, e.g., Ex. 4 at 142-58 (a November 5th visit
for a mammogram); id. at 159 (a November 8 th visit with an ophthalmologist). It is thus
reasonable that Petitioner did not bring up shoulder-related complaints during those visits.
More so, and contrary to Respondent’s assertions, I do not find Petitioner’s failure
to mention left shoulder complaints during her November 1, 2021 visit with an internal
medicine specialist to refill a prescription for meloxicam as dispositive on this issue. See
Ex. 4 at 169-70. While it would have been reasonable for Petitioner to have mentioned
musculoskeletal complaints to this treater – especially if Petitioner had previously
discussed her shoulder pain with this individual as they each claim (Ex. 7 ¶ 1; Ex. 11 at
1) – the fact that this visit was merely for a prescription refill (rather than a full examination)
provides some explanation for Petitioner not mentioning such complaints. Indeed, this
intervening visit alone is not enough to tip the scales against a favorable onset showing.
In addition, Petitioner affirmatively and repeatedly linked her shoulder pain to the
subject flu vaccine – beginning with the January 6 th treatment encounter, at which time
she reported left shoulder pain that she thought “could be related to [the] vaccination.”
Ex. 2 at 21. Although this entry does not preponderantly support Table onset on its own,
other subsequent medical records corroborate this entry with more detail and thus provide
support for a two-day onset showing. See, e.g., Ex. 4 at 115 (a January 21, 2022
orthopedic report that “[b]ack [on] 10/23/2021, she had a flu vaccine injection . . . and has
had pain since.”); id. at 107 (a January 25, 2022 PT note listing onset as “10/23/2021”
and reporting “left shoulder pain that appeared after receiving a flu shot in October” with
pain that has “been constant since its onset.”); id. at 15 (an April 25, 2022 orthopedic
history note of “persistent left shoulder pain after flu injection 10/23/2021.”).
Admittedly, some of Petitioner’s records suggest an onset beginning at some
unspecified time in “October 2021” or “after flu injection,” but I do not find this evidence to
negate Petitioner’s earlier reports supportive of an onset on October 23, 2021. See, e.g.,
Ex. 4 at 40, 78; Ex. 6 at 153-54, 272. In fact, Petitioner still reported her pain as beginning
in October 2021 “after” her receipt of the flu vaccine in question. These records are thus
consistent with her other reports of pain beginning after her subject vaccination and
provide further support for 48-hour onset.
Case 1:22-vv-00685-UNJ Document 42 Filed 01/06/26 Page 7 of 8

8
Finally, while there is one record entry (from Petitioner’s January 14, 2022 x-ray)
containing a report of pain “since getting flu shot 12/21” (Ex. 2 at 11), it is insufficient to
overcome the bulk of evidence that favors Petitioner on onset. In fact, the same record
includes Petitioner reporting her left shoulder pain as being present “since flu shot 3-4
months ago” – or around the time of her October 2021 vaccination. The contemporaneous
medical records thus establish that the onset of Petitioner’s injury occurred within the
timeframe required by the Table.
Conclusion
Petitioner has provided preponderant evidence that the onset of her shoulder pain
occurred within 48 hours of vaccination.
I thus encourage the parties to make a final re-attempt at informal resolution (of
settlement or damages). Respondent shall file, by no later than Friday, January 02,
2026, a status report concerning how he intends to proceed, including, if appropriate,
whether he would like to file an amended Rule 4(c) Report or whether he is otherwise
willing to entertain a renewed settlement demand from Petitioner.
IT IS SO ORDERED.
s/Brian H. Corcoran
Brian H. Corcoran
Chief Special Master
Case 1:22-vv-00685-UNJ Document 42 Filed 01/06/26 Page 8 of 8